中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
29期
3442-3445,3449
,共5页
刘丽娟%甄东户%汤旭磊%傅松波%吴晓燕%田昀灵%关聪会
劉麗娟%甄東戶%湯旭磊%傅鬆波%吳曉燕%田昀靈%關聰會
류려연%견동호%탕욱뢰%부송파%오효연%전윤령%관총회
代谢综合征%患病率%非酒精性脂肪性肝病
代謝綜閤徵%患病率%非酒精性脂肪性肝病
대사종합정%환병솔%비주정성지방성간병
Metabolic syndrome%Prevalence%Nonalcoholic fatty liver disease
目的:调查中老年人不同诊断标准下代谢综合征( MS)的患病情况,分析其与非酒精性脂肪性肝病( NAFLD)的关系。方法采取整群随机抽样方法,于2011年7-9月抽取兰州市五泉铁路西村街道社区中老年居民3125例进行调查。采用自行设计的标准化问卷,由统一培训的调查员进行面访调查及体格检查,测量调查对象身高、体质量、腰围、血压,检测空腹血糖(FPG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇( HDL - C )、丙氨酸氨基转移酶( ALT )、天冬氨酸氨基转移酶( AST )、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 hPG),所有调查对象行上腹部B超检查。结果2004中华医学会糖尿病学分会(CDS)标准下男性MS患病率为27.4%(242/882),高于女性的21.0%(472/2243)(χ2=14.68,P<0.01);2005国际糖尿病联盟(IDF)标准下男性MS患病率为36.7%(324/882),低于女性的42.5%(953/2243)(χ2=8.67,P <0.01);2007《中国成人血脂异常防治指南》制定联合委员会(JCDCG)标准下男性MS患病率为41.4%(365/882),高于女性的32.0%(717/2243)(χ2=24.80,P<0.01)。CDS标准下高血糖、高血压的检出率男性高于女性( P<0.05);IDF标准下FPG升高及血压升高检出率男性高于女性,而腹型肥胖、HDL-C降低检出率男性低于女性( P<0.05);JCDCG标准下HDL-C降低、血压升高、高血糖检出率男性高于女性( P<0.05)。3种诊断标准下MS患病率均随年龄增加而升高,在女性中升高趋势较为明显( P<0.05)。随着调查对象中个体MS各组分数目的增多,NAFLD的检出率逐渐增高(P<0.05)。以NAFLD分别取代IDF标准中除必须条件腹型肥胖以外的MS的4个组分(TG升高、HDL-C降低、血压升高、FPG升高)之一后,Kappa值分别为0.805、0.809、0.798、0.824(P<0.05),与原标准诊断结果具有较好的一致性。结论中老年人MS患病率较高,但患病率取决于所用的标准;NAFLD与MS关系密切,可以作为IDF标准下MS的组分。
目的:調查中老年人不同診斷標準下代謝綜閤徵( MS)的患病情況,分析其與非酒精性脂肪性肝病( NAFLD)的關繫。方法採取整群隨機抽樣方法,于2011年7-9月抽取蘭州市五泉鐵路西村街道社區中老年居民3125例進行調查。採用自行設計的標準化問捲,由統一培訓的調查員進行麵訪調查及體格檢查,測量調查對象身高、體質量、腰圍、血壓,檢測空腹血糖(FPG)、總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇( HDL - C )、丙氨痠氨基轉移酶( ALT )、天鼕氨痠氨基轉移酶( AST )、糖化血紅蛋白(HbA1c)、餐後2 h血糖(2 hPG),所有調查對象行上腹部B超檢查。結果2004中華醫學會糖尿病學分會(CDS)標準下男性MS患病率為27.4%(242/882),高于女性的21.0%(472/2243)(χ2=14.68,P<0.01);2005國際糖尿病聯盟(IDF)標準下男性MS患病率為36.7%(324/882),低于女性的42.5%(953/2243)(χ2=8.67,P <0.01);2007《中國成人血脂異常防治指南》製定聯閤委員會(JCDCG)標準下男性MS患病率為41.4%(365/882),高于女性的32.0%(717/2243)(χ2=24.80,P<0.01)。CDS標準下高血糖、高血壓的檢齣率男性高于女性( P<0.05);IDF標準下FPG升高及血壓升高檢齣率男性高于女性,而腹型肥胖、HDL-C降低檢齣率男性低于女性( P<0.05);JCDCG標準下HDL-C降低、血壓升高、高血糖檢齣率男性高于女性( P<0.05)。3種診斷標準下MS患病率均隨年齡增加而升高,在女性中升高趨勢較為明顯( P<0.05)。隨著調查對象中箇體MS各組分數目的增多,NAFLD的檢齣率逐漸增高(P<0.05)。以NAFLD分彆取代IDF標準中除必鬚條件腹型肥胖以外的MS的4箇組分(TG升高、HDL-C降低、血壓升高、FPG升高)之一後,Kappa值分彆為0.805、0.809、0.798、0.824(P<0.05),與原標準診斷結果具有較好的一緻性。結論中老年人MS患病率較高,但患病率取決于所用的標準;NAFLD與MS關繫密切,可以作為IDF標準下MS的組分。
목적:조사중노년인불동진단표준하대사종합정( MS)적환병정황,분석기여비주정성지방성간병( NAFLD)적관계。방법채취정군수궤추양방법,우2011년7-9월추취란주시오천철로서촌가도사구중노년거민3125례진행조사。채용자행설계적표준화문권,유통일배훈적조사원진행면방조사급체격검사,측량조사대상신고、체질량、요위、혈압,검측공복혈당(FPG)、총담고순(TC)、삼선감유(TG)、저밀도지단백담고순(LDL-C)、고밀도지단백담고순( HDL - C )、병안산안기전이매( ALT )、천동안산안기전이매( AST )、당화혈홍단백(HbA1c)、찬후2 h혈당(2 hPG),소유조사대상행상복부B초검사。결과2004중화의학회당뇨병학분회(CDS)표준하남성MS환병솔위27.4%(242/882),고우녀성적21.0%(472/2243)(χ2=14.68,P<0.01);2005국제당뇨병련맹(IDF)표준하남성MS환병솔위36.7%(324/882),저우녀성적42.5%(953/2243)(χ2=8.67,P <0.01);2007《중국성인혈지이상방치지남》제정연합위원회(JCDCG)표준하남성MS환병솔위41.4%(365/882),고우녀성적32.0%(717/2243)(χ2=24.80,P<0.01)。CDS표준하고혈당、고혈압적검출솔남성고우녀성( P<0.05);IDF표준하FPG승고급혈압승고검출솔남성고우녀성,이복형비반、HDL-C강저검출솔남성저우녀성( P<0.05);JCDCG표준하HDL-C강저、혈압승고、고혈당검출솔남성고우녀성( P<0.05)。3충진단표준하MS환병솔균수년령증가이승고,재녀성중승고추세교위명현( P<0.05)。수착조사대상중개체MS각조분수목적증다,NAFLD적검출솔축점증고(P<0.05)。이NAFLD분별취대IDF표준중제필수조건복형비반이외적MS적4개조분(TG승고、HDL-C강저、혈압승고、FPG승고)지일후,Kappa치분별위0.805、0.809、0.798、0.824(P<0.05),여원표준진단결과구유교호적일치성。결론중노년인MS환병솔교고,단환병솔취결우소용적표준;NAFLD여MS관계밀절,가이작위IDF표준하MS적조분。
Objective To explore the prevalence of the metabolic syndrome( MS)by different criteria and analyze its relationship to non-alcoholic fatty liver disease( NAFLD)in middle-aged and older individuals. Methods Using cluster ran-dom sampling method to choose 3 125 middle-aged and older residents from a community of Lanzhou from July to September 2011. We measured height,weight,waist circumference(WC),blood pressure(BP),determined the levels of fasting lasma glucose(FPG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),alanine aminotransferase(ALT),aspartate aminotransferase(AST),glycosylated hemo-globin(HbA1c),2 h postprandial blood glucose(2 hPG),and gave the respondents abdominal ultrasound-B. Results By 2004 Chinese Diabetes Society(CDS)Standards,the MS prevalence was 27. 4%(242/882)in men,higher than in women〔21. 0%(472/2 243)〕(χ2 =14. 68,P<0. 01);by 2005 International Diabetes Federation(IDF)Criteria,the MS preva-lence was 36. 7%(324/882)in men,lower than in women〔42. 5%(953/2 243)〕(χ2 =8. 67,P<0. 01);by 2007 China Adult Dyslipidemia Control Guide Joint Commission(JCDCG),the MS prevalence was 41. 4%(365/882)in men,higher than in women〔32. 0%(717/2 243)〕(χ2 =24. 80,P<0. 01). The detection rates of hyperglycemia,hypertension were higher in men than in women by CDS(P<0. 05);the detection rates of elevated FPG,BP were higher in men than in women, those of abdominal obesity,decreased HDL-C lower by IDF(P<0. 05);the detection rates of decreased HDL-C,elevated BP,hyperglycemia were higher in men than in women by JCDCG(P<0. 05). The MS prevalence increased with the increase of age by 3 diagnostic criteria,more obviously in women(P<0. 05). The more the MS components increased,the higher NAFLD detection rate was(P<0. 05). Using NAFLD to replace one of the 4 components of MS except abdominal obesity(elevated TG, decreased HDL-C,increased BP and FPG)in IDF,Kappa values were 0. 805,0. 809,0. 798,0. 824(P<0. 05),the di-agnostic results were of good consistency as compared with the original standards. Conclusion The incidence of MS,higher in middle-aged and older residents,depends on the criteria used. NAFLD is closely related to MS,which can be used as a com-ponent of MS by IDF.